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UNIVERSITY HEALTH SERVICES INC: Form 990, tax year 2011

View the entire original 990 at ProPublica ↗

Organization
UNIVERSITY HEALTH SERVICES INC (EIN 58-1581103)
Tax period
2011-01-01 to 2011-12-31
Filed
2012-11-13
IRS object ID
201233189349300513
Schema version
2011v1.2
Source
Download XML · Original 990 at ProPublica

Every field in the e-filed return. Faint text is the IRS element name, for citing.

Return header ReturnHeader

FieldValueIRS element (for citing)
Timestamp2012-11-13T04:46:04-08:00Timestamp
Tax Period End Date2011-12-31TaxPeriodEndDate
Return Type990ReturnType
Tax Period Begin Date2011-01-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN581581103EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1UNIVERSITY HEALTH SERVICES INCBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlUNIVNameControl
Phone7068282406Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line11350 WALTON WAYAddressLine1
CityAUGUSTACity
StateGAState
ZIP Code30901ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameDavid BelkoskiName
TitleCFOTitle
Date Signed2012-11-13DateSigned
FieldValueIRS element (for citing)
Tax Year2011TaxYear
Build TS2016-02-24 21:20:13ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonJames R DavisNameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line11350 Walton WayAddressLine1
CityAugustaCity
StateGAState
ZIP Code30901ZIPCode
FieldValueIRS element (for citing)
Gross Receipts489168155GrossReceipts
Group Return For AffiliatesfalseGroupReturnForAffiliates
All Affiliates IncludedfalseAllAffiliatesIncluded
Organization501c3XOrganization501c3
Web Sitewww.universityhealth.orgWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1984YearFormation
State Legal DomicileGAStateLegalDomicile
Activity Or Mission DescriptionThe mission of University Health Care Services is to operate an acute and subacute care hospital providing health care services which help the citizens of our communities achieve and maintain optimal health.ActivityOrMissionDescription
Nbr Voting Members Governing Body15NbrVotingMembersGoverningBody
Nbr Independent Voting Members14NbrIndependentVotingMembers
Total Nbr Employees3448TotalNbrEmployees
Total Nbr Volunteers343TotalNbrVolunteers
Total Gross UBI3988944TotalGrossUBI
Net Unrelated Business Txbl Income835066NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year2340067ContributionsGrantsPriorYear
Contributions Grants Current Year482697ContributionsGrantsCurrentYear
Program Service Revenue Prior Year362721760ProgramServiceRevenuePriorYear
Program Service Revenue CY366575614ProgramServiceRevenueCY
Investment Income Prior Year-3844762InvestmentIncomePriorYear
Investment Income Current Year11370512InvestmentIncomeCurrentYear
Other Revenue Prior Year5183238OtherRevenuePriorYear
Other Revenue Current Year8549487OtherRevenueCurrentYear
Total Revenue Prior Year366400303TotalRevenuePriorYear
Total Revenue Current Year386978310TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year1308770GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY1491840GrantsAndSimilarAmntsCY
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year174256345SalariesEtcPriorYear
Salaries Etc Current Year164000475SalariesEtcCurrentYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year183792894OtherExpensePriorYear
Other Expenses Current Year207315173OtherExpensesCurrentYear
Total Expenses Prior Year359358009TotalExpensesPriorYear
Total Expenses Current Year372807488TotalExpensesCurrentYear
Revenues Less Expenses Prior Year7042294RevenuesLessExpensesPriorYear
Revenues Less Expenses CY14170822RevenuesLessExpensesCY
Total Assets BOY690079783TotalAssetsBOY
Total Assets EOY680520097TotalAssetsEOY
Total Liabilities BOY292827610TotalLiabilitiesBOY
Total Liabilities EOY321768380TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY397252173NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY358751717NetAssetsOrFundBalancesEOY
Mission DescriptionThe mission of University Health Care Services is to operate an acute and subacute care hospital providing health care services which help the citizens of our communities achieve and maintain optimal health.MissionDescription
Significant New Program ServicesfalseSignificantNewProgramServices
Significant ChangefalseSignificantChange
Expense339861853Expense
Revenue366575614Revenue
DescriptionOperation of a general acute care and subacute care hospital with 551 licensed beds total (551 acute and 0 subacute). Patient days for adults and pediatrics for 2011 were 109,065, newborn days were 12,583 (for both term & ICU nursery), and outpatient visits were 261,821. Emergency room registrations were 72,807, observation stays were 5,390, Cardiovascular interventional procedures were 15,217, and Radiology procedures were 140,922, Occupational Medicine visits were 21,918 and Home Health visits for 2011 were 53,600. Within all these indicators are the efforts of University Health Services to service the needs of the community, which include the indigent. In 2011 the cost of indigent and charity care provided, with no local funding, was $28,813,764, however the Hospital did receive Disproportionate Share (DSH) payments to help with this service of $4,663,022 and Upper Payment Limit (UPL) funds of $1,630,337. The $28,813,764 includes the cost for providing inpatient and outpatient services for indigent and charity patients of $19,322,359. Also $1,794,505 to help support community based clinics, $7,488,260 for uncompensated physician services for indigent and charity patients, and $208,640 for disease management. Also provided are programs for congestive heart failure and asthma/COPD, which helped indigent patients manage their condition and improve the quality of their lives. Other community outreach services for 2011 included diabetes testing and education, Prostate Specific Antigen (PSA) testing, Skin Cancer Screenings, free counseling and education for women and their family members through all stages of breast cancer, free mammograms, heart health education, and support groups for cancer, heart attack, and stroke. In 2011, University Hospital reached more than 200,000 people and invested more than $2 million in free screenings, community education, publications, and more. Additionally, in 2011, over $750,000 was provided for health professional education for cardiovascular and radiology schools, and dietetic internships, in support of tomorrow's care givers.Description
Total Program Service Expense339861853TotalProgramServiceExpense
Described In501 C3trueDescribedIn501C3
Schedule B RequiredtrueScheduleBRequired
Political ActivitiesfalsePoliticalActivities
Lobbying ActivitiestrueLobbyingActivities
Subject To Proxy TaxfalseSubjectToProxyTax
Donor Advised FundsfalseDonorAdvisedFunds
Conservation EasementsfalseConservationEasements
Collections Of ArtfalseCollectionsOfArt
Credit CounselingfalseCreditCounseling
Term Or Permanent EndowmentsfalseTermOrPermanentEndowments
Report Land Bldg EquiptrueReportLandBldgEquip
Report Invest Oth SecuritiesfalseReportInvestOthSecurities
Report Prog Rel InvestfalseReportProgRelInvest
Report Other AssetsfalseReportOtherAssets
Report Other LiabilitiestrueReportOtherLiabilities
Report Fin48 FootnotetrueReportFin48Footnote
Independent Audit Financial StmtfalseIndependentAuditFinancialStmt
Consolidated Audit Financial StmttrueConsolidatedAuditFinancialStmt
SchoolfalseSchool
Foreign OfficetrueForeignOffice
Foreign ActivitiestrueForeignActivities
More Than5000 K To OrganizationsfalseMoreThan5000KToOrganizations
More Than5000 K To IndividualsfalseMoreThan5000KToIndividuals
Professional FundraisingfalseProfessionalFundraising
Fundraising ActivitiesfalseFundraisingActivities
GamingfalseGaming
HospitaltrueHospital
Financial Stmt AttachedtrueFinancialStmtAttached
Grants To OrganizationstrueGrantsToOrganizations
Grants To IndividualsfalseGrantsToIndividuals
Schedule J RequiredtrueScheduleJRequired
Tax Exempt BondstrueTaxExemptBonds
Invest Tax Exempt BondsfalseInvestTaxExemptBonds
Escrow AccountfalseEscrowAccount
On Behalf Of IssuerfalseOnBehalfOfIssuer
Excess Benefit TransactionfalseExcessBenefitTransaction
Prior Excess Benefit TransactionfalsePriorExcessBenefitTransaction
Loan To Officer Or DQPfalseLoanToOfficerOrDQP
Grant To Related PersonfalseGrantToRelatedPerson
Bsnss Rltnshp With OrganizationfalseBsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family MemberfalseBsnssRltnshpThruFamilyMember
Officer Entity With Bsnss RltnshpfalseOfficerEntityWithBsnssRltnshp
Deductible Non Cash ContributionsfalseDeductibleNonCashContributions
Deductible Contributions Of ArtfalseDeductibleContributionsOfArt
TerminatedfalseTerminated
Partial LiquidationfalsePartialLiquidation
Disregarded EntitytrueDisregardedEntity
Related EntitytrueRelatedEntity
Related Org Controlled EntityfalseRelatedOrgControlledEntity
Transaction Related EntityfalseTransactionRelatedEntity
Transfers To Exempt Non Chrtbl OrgfalseTransfersToExemptNonChrtblOrg
Activities Conducted PartnershipfalseActivitiesConductedPartnership
Schedule O RequiredtrueScheduleORequired
Number Forms Transmitted With1096221NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup WitholdingtrueComplianceWithBackupWitholding
Number Of Employees3448NumberOfEmployees
Employment Tax Returns FiledtrueEmploymentTaxReturnsFiled
Unrelated Business IncometrueUnrelatedBusinessIncome
Form990-T FiledtrueForm990-TFiled
Foreign Financial AccounttrueForeignFinancialAccount
Name Of Foreign CountryCJNameOfForeignCountry
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTrans
Taxable Party NotificationfalseTaxablePartyNotification
Form8886 T FiledfalseForm8886TFiled
Non Deductible ContributionsfalseNonDeductibleContributions
Non Deductible DisclosurefalseNonDeductibleDisclosure
Quid Pro Quo ContributionsfalseQuidProQuoContributions
Quid Pro Quo DisclosurefalseQuidProQuoDisclosure
Form8282 Property Disposed OffalseForm8282PropertyDisposedOf
Number Of8282 Filed0NumberOf8282Filed
Funds To Pay PremiumsfalseFundsToPayPremiums
Premiums PaidfalsePremiumsPaid
Form8899 FiledfalseForm8899Filed
Form1098 C FiledfalseForm1098CFiled
Excess Business HoldingsfalseExcessBusinessHoldings
Taxable DistributionsfalseTaxableDistributions
Distribution To DonorfalseDistributionToDonor
Filed Lieu1041falseFiledLieu1041
Licensed More Than One StatefalseLicensedMoreThanOneState
Indoor Tanning ServicesfalseIndoorTanningServices
Form720 FiledfalseForm720Filed
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members15NbrVotingGoverningBodyMembers
Number Independent Voting Members14NumberIndependentVotingMembers
Family Or Business RelationshipfalseFamilyOrBusinessRelationship
Delegation Of Management DutiesfalseDelegationOfManagementDuties
Changes To Organizing DocsfalseChangesToOrganizingDocs
Material Diversion Or MisusefalseMaterialDiversionOrMisuse
Members Or StockholdersfalseMembersOrStockholders
Election Of Board MembersfalseElectionOfBoardMembers
Decisions Subject To ApprovalfalseDecisionsSubjectToApproval
Minutes Of Governing BodytrueMinutesOfGoverningBody
Minutes Of CommitteestrueMinutesOfCommittees
Officer Mailing AddressfalseOfficerMailingAddress
Local ChapterstrueLocalChapters
Policies Reference ChapterstruePoliciesReferenceChapters
Form990 Provided To Governing BodytrueForm990ProvidedToGoverningBody
Conflict Of Interest PolicytrueConflictOfInterestPolicy
Annual Disclosure Covered PersonstrueAnnualDisclosureCoveredPersons
Regular Monitoring EnforcementtrueRegularMonitoringEnforcement
Whistleblower PolicytrueWhistleblowerPolicy
Document Retention PolicytrueDocumentRetentionPolicy
Compensation Process CEOtrueCompensationProcessCEO
Compensation Process OthertrueCompensationProcessOther
Investment In Joint VenturetrueInvestmentInJointVenture
Written Policy Or ProceduretrueWrittenPolicyOrProcedure
States Where Copy Of Return Is FiledGAStatesWhereCopyOfReturnIsFiled
Other WebsiteXOtherWebsite
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

FieldValueIRS element (for citing)
Name PersonDavid BelkoskiNamePerson
Telephone Number7068282406TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line11350 Walton WayAddressLine1
CityAugustaCity
StateGAState
ZIP Code30901ZIPCode

Form990 Part VII Section A Form990PartVIISectionA (31 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationOfficerOfficerKey EmployeeKeyEmployeeHighest Compensated EmployeeHighestCompensatedEmployee
John P Rhodes
Board Member2.00X000
Richard K Fairey
Board Member2.00X000
Thomas A Parfenchuck MD
Board Member2.00X000
Thomas E Sizemore
Board Member2.00X000
Wyck A Knox Jr
Board Member2.00X000
Hugh L Hamilton
Board Member2.00X000
Jerry W Howington MD
Board Member2.00X000
Terry D Elam
Board Member2.00X000
Natalie D Schweers
Board Member2.00X000
Eugene F McManus
Board Member2.00X000
Reverend Clyde Hill Sr
Board Member2.00X000
Steven B Vaughn MD
Board Member50.00X13151500
Gerald E Matheis
Board Member2.00X000
Brian J Marks
Board Secretary2.00X000X
R Lee Smith Jr
Board Chairman2.00X000X
William L Farr Jr
CMO50.00457288037652X
Marilyn A Bowcutt
COO50.00342970062521X
Dave A Belkoski
Exec VP/CFO50.00528031042471X
James R Davis
President & CEO50.006077220239093X
Stephen M Gooden
VP-Physician Practices45.0025934209463X
Shannon M Stinson MD
VP-Chief Medical Informatics45.00305360016327X
Leslie A Clonch
VP-Information Systems45.0018949308866X
Kyle E Howell
VP-Support & Facilities45.00423768034757X
Brent J Mallek
VP-Human Resources40.00293570028759X
Joan F Wessman
VP-Patient Care Services45.00294610021690X
Edward L Burr
VP-Legal Affairs-Compliance50.00291997080567X
Teresa Waters
Director45.00164890025217X
Richard W Severson
Director45.00154915031463X
Lynda Jones Watts
Director45.00148048021510X
Christine A Martin
Epic -Surgical SVC45.00137172020346X
Tara A Kattine
PHYSICIAN40.00212536014759X
FieldValueIRS element (for citing)
Total Reportable Comp From Org4943227TotalReportableCompFromOrg
Total Other Compensation695461TotalOtherCompensation
Number Individuals GT100 K17NumberIndividualsGT100K
Formers ListedfalseFormersListed
Total Comp GT150 KtrueTotalCompGT150K
Compensation From Other SourcesfalseCompensationFromOtherSources

Contractor Compensation ContractorCompensation (5 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1CityAddressOfContractor/AddressUS/CityStateAddressOfContractor/AddressUS/StateZIP CodeAddressOfContractor/AddressUS/ZIPCodeDescription Of ServicesDescriptionOfServicesCompensationCompensation
Morrisons Management Specialists
PO Box 102289AtlantaGA30368Food Services5429837
IN COMPASS HEALTH
318 Maxwell Road Suite 500AlpharettaGA30004Physician Services1562362
EPIC Systems Corporation
PO BOX 88314MilwaukeeWI53288EPIC Support1319095
Crothall Laundry Services
901 RA Dent BlvdAugustaGA30901Linen Services2488599
Crothall Healthcare
955 Chesterbrooks BlvdWaynePA19087Plant & Houskeeping7814195
FieldValueIRS element (for citing)
Number Of Contractors GT100 K56NumberOfContractorsGT100K
Federated Campaigns293537FederatedCampaigns
Government Grants53070GovernmentGrants
All Other Contributions136090AllOtherContributions
Total Contributions482697TotalContributions

Program Service Revenue ProgramServiceRevenue (5 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncome
Physician Answering SVC541900407151407151
Patient Service Revenue900099356799001356799001
Other Program Services900099336083336083
Home Health Services62161070433827043382
Admin Support Services90009916531551653155

Total Oth Program Service Revenue TotalOthProgramServiceRevenue

FieldValueIRS element (for citing)
Total Revenue Column336842TotalRevenueColumn
Related Or Exempt Function Income336842RelatedOrExemptFunctionIncome
FieldValueIRS element (for citing)
Total Program Service Revenue366575614TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column9742768TotalRevenueColumn
Related Or Exempt Function Income9742768RelatedOrExemptFunctionIncome

Income From Invest Bond Proceeds IncomeFromInvestBondProceeds

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Royalties Revenue RoyaltiesRevenue

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Gross Rents GrossRents

FieldValueIRS element (for citing)
Real3095447Real
Personal35746Personal

Less Rental Expenses LessRentalExpenses

FieldValueIRS element (for citing)
Real2084260Real

Rental Income Or Loss RentalIncomeOrLoss

FieldValueIRS element (for citing)
Real1011187Real
Personal35746Personal

Net Rental Income Or Loss NetRentalIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column1046933TotalRevenueColumn
Unrelated Business Revenue72129UnrelatedBusinessRevenue
Exclusion$974,804ExclusionAmount

Gross Amount Sales Assets GrossAmountSalesAssets

FieldValueIRS element (for citing)
Securities101703093Securities
Other30236Other

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

FieldValueIRS element (for citing)
Securities99916737Securities
Other188848Other

Gain Or Loss GainOrLoss

FieldValueIRS element (for citing)
Securities1786356Securities
Other-158612Other

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column1627744TotalRevenueColumn
Exclusion$1,627,744ExclusionAmount

Net Income From Fundraising Events NetIncomeFromFundraisingEvents

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Net Income From Gaming NetIncomeFromGaming

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Net Income Or Loss NetIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Other Revenue Misc OtherRevenueMisc (3 entries)

DescriptionDescriptionTotal Revenue ColumnTotalRevenueColumnUnrelated Business RevenueUnrelatedBusinessRevenueBusiness CodeBusinessCodeRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncomeExclusionExclusionAmount
Outreach Lab39168153916815
Miscellaneous273003900099273003
Employee Pharmacy2654002446110$2,654,002

Miscellaneous Revenue MiscellaneousRevenue

FieldValueIRS element (for citing)
Total Revenue Column658734TotalRevenueColumn
Related Or Exempt Function Income359401RelatedOrExemptFunctionIncome
Exclusion$299,333ExclusionAmount
FieldValueIRS element (for citing)
Total Other Revenue7502554TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column386978310TotalRevenueColumn
Related Or Exempt Function Income376950786RelatedOrExemptFunctionIncome
Unrelated Business Revenue3988944UnrelatedBusinessRevenue
Exclusion$5,555,883ExclusionAmount

Grants To Domestic Orgs GrantsToDomesticOrgs

FieldValueIRS element (for citing)
Total1491840Total
Program Services1491840ProgramServices

Grants To Domestic Individuals GrantsToDomesticIndividuals

FieldValueIRS element (for citing)
Total0Total

Foreign Grants ForeignGrants

FieldValueIRS element (for citing)
Total0Total

Benefits To Members BenefitsToMembers

FieldValueIRS element (for citing)
Total0Total

Comp Current Officers Directors CompCurrentOfficersDirectors

FieldValueIRS element (for citing)
Total4707833Total
Program Services1134307ProgramServices
Management And General3573526ManagementAndGeneral

Comp Disqual Persons CompDisqualPersons

FieldValueIRS element (for citing)
Total0Total

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total112888352Total
Program Services106679493ProgramServices
Management And General6208859ManagementAndGeneral

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total7686022Total
Program Services7263291ProgramServices
Management And General422731ManagementAndGeneral

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total28852226Total
Program Services27265354ProgramServices
Management And General1586872ManagementAndGeneral

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total9866042Total
Program Services9323410ProgramServices
Management And General542632ManagementAndGeneral

Fees For Services Management FeesForServicesManagement

FieldValueIRS element (for citing)
Total14644576Total
Program Services13839124ProgramServices
Management And General805452ManagementAndGeneral

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total282866Total
Management And General282866ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total216613Total
Management And General216613ManagementAndGeneral

Fees For Services Lobbying FeesForServicesLobbying

FieldValueIRS element (for citing)
Total228234Total
Management And General228234ManagementAndGeneral

Fees For Services Prof Fundraising FeesForServicesProfFundraising

FieldValueIRS element (for citing)
Total0Total

Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees

FieldValueIRS element (for citing)
Total1227540Total
Management And General1227540ManagementAndGeneral

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total19154193Total
Program Services18100712ProgramServices
Management And General1053481ManagementAndGeneral

Advertising Advertising

FieldValueIRS element (for citing)
Total1612432Total
Program Services1523748ProgramServices
Management And General88684ManagementAndGeneral

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total1394389Total
Program Services1317698ProgramServices
Management And General76691ManagementAndGeneral

Information Technology InformationTechnology

FieldValueIRS element (for citing)
Total6668208Total
Program Services6301457ProgramServices
Management And General366751ManagementAndGeneral

Royalties Royalties

FieldValueIRS element (for citing)
Total0Total

Occupancy Occupancy

FieldValueIRS element (for citing)
Total15387910Total
Program Services14541575ProgramServices
Management And General846335ManagementAndGeneral

Travel Travel

FieldValueIRS element (for citing)
Total862868Total
Program Services812845ProgramServices
Management And General50023ManagementAndGeneral

Travel Entrtnmnt Public Officials TravelEntrtnmntPublicOfficials

FieldValueIRS element (for citing)
Total0Total

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total0Total

Interest Interest

FieldValueIRS element (for citing)
Total8305339Total
Management And General8305339ManagementAndGeneral

Payments To Affiliates PaymentsToAffiliates

FieldValueIRS element (for citing)
Total0Total

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total26612332Total
Program Services25148654ProgramServices
Management And General1463678ManagementAndGeneral

Insurance Insurance

FieldValueIRS element (for citing)
Total2993752Total
Program Services2829096ProgramServices
Management And General164656ManagementAndGeneral

Other Expenses OtherExpenses (5 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesManagement And GeneralManagementAndGeneral
Med Surg supplies7461345374613453
General Supplies39330483716730216318
GA DCH Hospital Tax50596665059666
Dues,Memberships, Misc Fees1456427137632480103
Bad Debt Expense2258274222582742

All Other Expenses AllOtherExpenses

FieldValueIRS element (for citing)
Total78585Total
Management And General78585ManagementAndGeneral

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total372807488Total
Program Services339861853ProgramServices
Management And General32945635ManagementAndGeneral
Fundraising0Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY39893732BOY
EOY31019669EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY21337929BOY
EOY22152854EOY

Pledges And Grants Receivable PledgesAndGrantsReceivable

FieldValueIRS element (for citing)
EOY0EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY63422064BOY
EOY55796887EOY

Receivables From Officers Etc ReceivablesFromOfficersEtc

FieldValueIRS element (for citing)
EOY0EOY

Receivables From Disqual Persons ReceivablesFromDisqualPersons

FieldValueIRS element (for citing)
EOY0EOY

Other Notes Loans Receivable Net OtherNotesLoansReceivableNet

FieldValueIRS element (for citing)
BOY11853506BOY
EOY9643330EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

FieldValueIRS element (for citing)
BOY6734447BOY
EOY6700122EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY8780030BOY
EOY7019777EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis476853776LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec256865146LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY217398855BOY
EOY219988630EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

FieldValueIRS element (for citing)
BOY305534935BOY
EOY294373453EOY

Investments Other Securities InvestmentsOtherSecurities

FieldValueIRS element (for citing)
EOY0EOY

Investments Program Related InvestmentsProgramRelated

FieldValueIRS element (for citing)
EOY0EOY

Intangible Assets IntangibleAssets

FieldValueIRS element (for citing)
EOY0EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY15124285BOY
EOY33825375EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY690079783BOY
EOY680520097EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY15667534BOY
EOY17176913EOY

Tax Exempt Bond Liabilities TaxExemptBondLiabilities

FieldValueIRS element (for citing)
BOY150965982BOY
EOY148650743EOY

Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp

FieldValueIRS element (for citing)
BOY4540194BOY
EOY4738710EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY121653900BOY
EOY151202014EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY292827610BOY
EOY321768380EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY397217173BOY
EOY358716717EOY

Permanently Restricted Net Assets PermanentlyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY35000BOY
EOY35000EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY397252173BOY
EOY358751717EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY690079783BOY
EOY680520097EOY
FieldValueIRS element (for citing)
Info In Schedule O Part XIXInfoInScheduleOPartXI
Reconcilation Revenue Expenses14170822ReconcilationRevenueExpenses
Reconcilation Other Changes-52671278ReconcilationOtherChanges
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or ReviewfalseAccountantCompileOrReview
FS AuditedtrueFSAudited
Audit CommitteetrueAuditCommittee
Financial Statement ConsolidatedXFinancialStatementConsolidated
Federal Grant Audit RequiredfalseFederalGrantAuditRequired
Federal Grant Audit PerformedfalseFederalGrantAuditPerformed

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Hospital170b1 AiiiXHospital170b1Aiii

Schedule B IRS990ScheduleB

Contributor Info ContributorInfo

FieldValueIRS element (for citing)
Contributor NumberRESTRICTEDContributorNumber

Contributor Name Business ContributorNameBusiness

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor Address US ContributorAddressUS

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Aggregate ContributionsRESTRICTEDAggregateContributions

Schedule C IRS990ScheduleC

FieldValueIRS element (for citing)
Form4720 Filed4955 TaxfalseForm4720Filed4955Tax
Correction MadefalseCorrectionMade
VolunteersfalseVolunteers
Paid Staff Or ManagementfalsePaidStaffOrManagement
Media AdvertisementsfalseMediaAdvertisements
Mailings MembersfalseMailingsMembers
Publications Or BroadcastfalsePublicationsOrBroadcast
Grants Other OrganizationsfalseGrantsOtherOrganizations
Direct Contact LegislatorsfalseDirectContactLegislators
Rallies DemonstrationsfalseRalliesDemonstrations
Other ActivitiestrueOtherActivities
Other Activities$228,234OtherActivitiesAmount
Total Lobbying Expenditures IIB228234TotalLobbyingExpendituresIIB
Not Described In501c3falseNotDescribedIn501c3
Form4720 Filed4912 TaxfalseForm4720Filed4912Tax

Form990 Schedule C Part IV Form990ScheduleCPartIV

FieldValueIRS element (for citing)
IdentifierPart II-B, Line 1iIdentifier
Return ReferencePart II-B, Line 1i - Other Activities DescriptionReturnReference
ExplanationA part of the various association dues include a percentage allocation for expenditures on Lobbying activities. Dues paid to the Georgia Hospital Association, The American Hospital Association, the Georgia Alliance of Community Hospitals and The Georgia Initiative, all have a lobby component. For 2011 these fees amounted to $140,234. Additionally, Oglethorpe Consulting Group was contracted during 2011 to review and advise the Hospital on legislative issues. During 2011 $88,000 was paid to Oglethorpe Consulting Group.Explanation

Schedule D IRS990ScheduleD

Land Land

FieldValueIRS element (for citing)
Other Cost Or Other Basis14518882OtherCostOrOtherBasis
Book Value14518882BookValue

Buildings Buildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis245154270OtherCostOrOtherBasis
Depreciation105246695Depreciation
Book Value139907575BookValue

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis213046714OtherCostOrOtherBasis
Depreciation151618451Depreciation
Book Value61428263BookValue

Other Land Buildings OtherLandBuildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis4133910OtherCostOrOtherBasis
Book Value4133910BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings219988630TotalOfBookValueLandBuildings

Other Liabilities OtherLiabilities (7 entries)

DescriptionDescriptionAmountAmount
Reserve for Self Insured Losses$22,451,472
Other Current Liabilities$2,903,969
Est Third Party Payor Settlements$15,504,238
Asset Retirement Obligation$2,699,600
Accrued postretirement benefit cost$32,323,673
Accrued Pension Cost$56,430,647
Accrued Compensation, Benefits, & PR Tax$18,888,415
FieldValueIRS element (for citing)
Total Of Amounts151202014TotalOfAmounts
Total Revenue386978310TotalRevenue
Total Expenses372807488TotalExpenses
Excess Or Deficit For Year14170822ExcessOrDeficitForYear
Net Unrealized GL On Investments-18700252NetUnrealizedGLOnInvestments
Other-$33,971,026OtherAmount
Total Adjustments-52671278TotalAdjustments
Excess Or Deficit Per FS-38500456ExcessOrDeficitPerFS
Tot Revenue Etc Audited Fincl Stmt370931926TotRevenueEtcAuditedFinclStmt
Net Unrealized Gains Investments-18700252NetUnrealizedGainsInvestments
Other Revenues3881408OtherRevenues
Revenue Not Rptd F990-14818844RevenueNotRptdF990
Revenue Subtotal385750770RevenueSubtotal
Other Revenues Not Included1227540OtherRevenuesNotIncluded
Revenue Not Rptd On Fin Stmt1227540RevenueNotRptdOnFinStmt
Total Revenue Per Form990386978310TotalRevenuePerForm990
Tot Expenses Etc Audited Fincl Stmt376030515TotExpensesEtcAuditedFinclStmt
Other Expenses Included4017981OtherExpensesIncluded
Expenses Not Rptd F9904017981ExpensesNotRptdF990
Expenses Subtotal372012534ExpensesSubtotal
Other Expenses Not Included794954OtherExpensesNotIncluded
Expenses Not Rptd On Fin Stmt794954ExpensesNotRptdOnFinStmt
Total Expenses Per Form990372807488TotalExpensesPerForm990

Form990 Schedule D Part XIV Form990ScheduleDPartXIV (6 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
Part XPart X : FIN48 FootnoteAccounting for Income Taxes - University Health Services is exempt from federal income tax under Section 501(a) as organizations described in Section 501(c)(3) of the Internal Revenue Code of 1986, as amended. Accordingly, the accompanying financial statements do not reflect a provision or liability for federal and state income taxes. University Health Services has evaluated their tax positions and determined that they do not have any material unrecognized tax benefits or obligations as of December 31, 2011. Fiscal years ended no or after December 31, 2008 remain subject to examination by federal and state authorities.There is presently no taxation imposed by the government of the Cayman Islands on income or premiums of WWI. As a result, no tax liability or expense has been recorded.
Part XIII, Line 4bPart XIII, Line 4b: Other revenue amounts included on 990 but not included in F/SBad Debt Expense $0 Investment manager fees $1227540 Steam/Elect reimb, netted to exp $-432586
Part XIII, Line 2dPart XIII, Line 2d: Other expenses and losses per audited F/SExpenses netted to rental income $2084260 UHCF Exp on Consolidated AFS $2040473 UHCF Elimination entries on AFS $-106752
Part XII, Line 4bPart XII, Line 4b: Other revenue amounts included on 990 but not included in F/SBad Debt expense, in revenue on Audit $0 Investment mgr fees, in revenue on audit $1227540
Part XII, Line 2dPart XII, Line 2d: Other revenue amounts included in F/S but not included on form 990Steam/Electric Reimb-netted against exp $432586 Rental Expenses shown net on 990 $2084260 UHCF Unrest Revenue on Consolidated AFS $1471314 UHCF Revenue eliminations on AFS $-106752
Part XI, Line 8Part XI, Line 8: Other Changes in Net Assets or Fund BalancesOther Cumulative effect on Assets Retirement Obligation $157323 Tranfer to affiliate $ -710949 Cumulative effects on assets retirement obligations $ -0 Changes in Unfunded Pension/Postretirement Loses $ -32624618 Loss on Discontinued Operations $ -792782

Schedule F IRS990ScheduleF

Accts Actvs Out US Table AcctsActvsOutUSTable

FieldValueIRS element (for citing)
RegionCaribbeanRegion
Number Of Offices1NumberOfOffices
Number Of Employees2NumberOfEmployees
Type Of Activities ConductedInsurance CaptiveTypeOfActivitiesConducted
Total Expenditures2422916TotalExpenditures
FieldValueIRS element (for citing)
Subtotal Number Of Offices1SubtotalNumberOfOffices
Subtotal Number Of Employees2SubtotalNumberOfEmployees
Total Number Of Offices1TotalNumberOfOffices
Total Number Of Employees2TotalNumberOfEmployees
Subtotal Amount Spent2422916SubtotalAmountSpent
Total Amount Spent2422916TotalAmountSpent
No Recipient Over5 KXNoRecipientOver5K
Transfer To Foreign CorpfalseTransferToForeignCorp
Interest In Foreign TrustfalseInterestInForeignTrust
Own Foreign CorpfalseOwnForeignCorp
Passive Foreign Invest CofalsePassiveForeignInvestCo
Foreign PartnershipfalseForeignPartnership
Boycott CountriesfalseBoycottCountries

Form990 Schedule F Part V Form990ScheduleFPartV

FieldValueIRS element (for citing)
IdentifierAdditional Supplemental InformationIdentifier
ExplanationPlease see form 5471 filing for details related to Offshore Captive InsuranceExplanation

Schedule H IRS990ScheduleH

FieldValueIRS element (for citing)
Charity Care PolicytrueCharityCarePolicy
Written PolicytrueWrittenPolicy
FPG Reference Free CaretrueFPGReferenceFreeCare
Pcent200XPcent200
FPG Reference Discounted CaretrueFPGReferenceDiscountedCare
Pcent400XPcent400
Free Disc Care Medically IndigenttrueFreeDiscCareMedicallyIndigent
Amounts Budgeted For Charity CaretrueAmountsBudgetedForCharityCare
Expenses Exceeded BudgettrueExpensesExceededBudget
Unable To Provide CarefalseUnableToProvideCare
Annual Community Benefit ReporttrueAnnualCommunityBenefitReport
Report Publically AvailabletrueReportPublicallyAvailable

Charity Care At Cost CharityCareAtCost

FieldValueIRS element (for citing)
Total Community Benefit Expense18022757TotalCommunityBenefitExpense
Direct Offsetting Revenue2479023DirectOffsettingRevenue
Net Community Benefit Expense15543734NetCommunityBenefitExpense
Percent Of Total Expense0.04170PercentOfTotalExpense

Unreimbursed Medicaid UnreimbursedMedicaid

FieldValueIRS element (for citing)
Total Community Benefit Expense38853223TotalCommunityBenefitExpense
Direct Offsetting Revenue34072068DirectOffsettingRevenue
Net Community Benefit Expense4781155NetCommunityBenefitExpense
Percent Of Total Expense0.01280PercentOfTotalExpense

Total Charity Care TotalCharityCare

FieldValueIRS element (for citing)
Total Community Benefit Expense56875980TotalCommunityBenefitExpense
Direct Offsetting Revenue36551091DirectOffsettingRevenue
Net Community Benefit Expense20324889NetCommunityBenefitExpense
Percent Of Total Expense0.05450PercentOfTotalExpense

Community Health Services CommunityHealthServices

FieldValueIRS element (for citing)
Total Community Benefit Expense10441489TotalCommunityBenefitExpense
Direct Offsetting Revenue582233DirectOffsettingRevenue
Net Community Benefit Expense9859256NetCommunityBenefitExpense
Percent Of Total Expense0.02640PercentOfTotalExpense

Health Professions Education HealthProfessionsEducation

FieldValueIRS element (for citing)
Total Community Benefit Expense817764TotalCommunityBenefitExpense
Direct Offsetting Revenue137824DirectOffsettingRevenue
Net Community Benefit Expense679940NetCommunityBenefitExpense
Percent Of Total Expense0.00180PercentOfTotalExpense

Cash And In Kind Contributions CashAndInKindContributions

FieldValueIRS element (for citing)
Total Community Benefit Expense1510149TotalCommunityBenefitExpense
Net Community Benefit Expense1510149NetCommunityBenefitExpense
Percent Of Total Expense0.00410PercentOfTotalExpense

Total Other Benefits TotalOtherBenefits

FieldValueIRS element (for citing)
Total Community Benefit Expense12769402TotalCommunityBenefitExpense
Direct Offsetting Revenue720057DirectOffsettingRevenue
Net Community Benefit Expense12049345NetCommunityBenefitExpense
Percent Of Total Expense0.03230PercentOfTotalExpense

Total Community Benefits TotalCommunityBenefits

FieldValueIRS element (for citing)
Total Community Benefit Expense69645382TotalCommunityBenefitExpense
Direct Offsetting Revenue37271148DirectOffsettingRevenue
Net Community Benefit Expense32374234NetCommunityBenefitExpense
Percent Of Total Expense0.08680PercentOfTotalExpense

Community Support CommunitySupport

FieldValueIRS element (for citing)
Total Community Building Expense183324TotalCommunityBuildingExpense
Net Community Building Expense183324NetCommunityBuildingExpense
Percent Of Total Expense0.00050PercentOfTotalExpense

Total Total

FieldValueIRS element (for citing)
Total Community Building Expense183324TotalCommunityBuildingExpense
Net Community Building Expense183324NetCommunityBuildingExpense
Percent Of Total Expense0.00050PercentOfTotalExpense
FieldValueIRS element (for citing)
Bad Debt Expense ReportedtrueBadDebtExpenseReported
Bad Debt Expense$22,582,741BadDebtExpenseAmount
Amount Attributable To3161584AmountAttributableTo
Amount Reimbursed By Medicare107776647AmountReimbursedByMedicare
Cost Of Care Reimbursed By Medicare130677996CostOfCareReimbursedByMedicare
Medicare Surplus Or Shortfall-22901349MedicareSurplusOrShortfall

Costing Methodology Used CostingMethodologyUsed

FieldValueIRS element (for citing)
Cost To Charge RatioXCostToChargeRatio
FieldValueIRS element (for citing)
Written Debt Collection PolicytrueWrittenDebtCollectionPolicy
Provision For Charity CaretrueProvisionForCharityCare
Number Of Hospital Facilities1NumberOfHospitalFacilities

Form990 Schedule H Part V Section A Form990ScheduleHPartVSectionA

FieldValueIRS element (for citing)
Facility Number0FacilityNumber

Name Name

FieldValueIRS element (for citing)
Business Name Line1UHS University HospitalBusinessNameLine1

Address Address

FieldValueIRS element (for citing)
Address Line11350 Walton WayAddressLine1
CityAugustaCity
StateGAState
ZIP Code30901ZIPCode
FieldValueIRS element (for citing)
Licensed HospitalXLicensedHospital
General Medical And SurgicalXGeneralMedicalAndSurgical
Teaching HospitalXTeachingHospital
Er24 HoursXEr24Hours
Other3 Hospital Based Home Health AgenciesOther

Form990 Schedule H Part V Section B Form990ScheduleHPartVSectionB

Hospital Facility Name HospitalFacilityName

FieldValueIRS element (for citing)
Business Name Line1UHS University HospitalBusinessNameLine1
FieldValueIRS element (for citing)
Hospital Facility Number1HospitalFacilityNumber
CHNA ConductedfalseCHNAConducted
Eligibility Criteria ExplainedtrueEligibilityCriteriaExplained
Uses FPG FreetrueUsesFPGFree
FPG Free Percent200.0000FPGFreePercent
Uses FPG DiscountedtrueUsesFPGDiscounted
FPG Discount Percent400.0000FPGDiscountPercent
Explains BasistrueExplainsBasis
Income LevelXIncomeLevel
Asset LevelXAssetLevel
Medical IndigencyXMedicalIndigency
Insurance StatusXInsuranceStatus
Uninsured DiscountXUninsuredDiscount
Explains Application MethodtrueExplainsApplicationMethod
Includes Publicity MeasurestrueIncludesPublicityMeasures
Posted On WebsiteXPostedOnWebsite
Posted In Emergency RoomXPostedInEmergencyRoom
Posted In Admission OfficeXPostedInAdmissionOffice
Available On RequestXAvailableOnRequest
Other PublicityXOtherPublicity
Actions On NonpaymenttrueActionsOnNonpayment
Permit Report To Credit AgencyXPermitReportToCreditAgency
Permit LawsuitXPermitLawsuit
Permit Lien On ResidenceXPermitLienOnResidence
Collection ActivitiesfalseCollectionActivities
Nondiscrim Emergency Care PolicytrueNondiscrimEmergencyCarePolicy
Average Negotiated RatesXAverageNegotiatedRates
Amounts Generally BilledfalseAmountsGenerallyBilled
Gross ChargesfalseGrossCharges

Form990 Schedule H Part VI Form990ScheduleHPartVI (13 entries)

Return ReferenceReturnReferenceExplanationExplanationIdentifierIdentifier
Part VI - Additional InformationPart III, Section C-Collection Practices-Question 9aThe Catastrophic Policy allows for the Collection Department to apply the Indigent criteria and write-off the account. And at any point during the collection process if patient is believed that he/she can not afford to pay then an indigent/Charity Care application is begun by the Collection Department.
Part V - Explanation of Number of Facility TypeUH owns and operates three (3) Home Health Agencies as hospital-based agencies.
Part VI - Explanation Of How Organization Furthers Its Exempt PurposeUH governing Board members are comprised of citizens who reside in the UH's primary service area and are not employees of UH. UH Board members are active in the community and are eager to improve the health and welfare of the community. Several of UH Board Members worked with the local State Medical School to get interns & residents at the hospital since UH is among several counties that have been deemed as a Health Professional Shortage Area (HPSA). UH extends medical staff privileges to all qualified physicians in our community for all of the UH Departments.UH works with the Greater Augusta Healthcare Network (GAHN) which is made up of area hospitals and the local Medical Colleges School of Nursing and area primary care clinics. This group addresses the primary and specialty care needs in the community. Also UH supports the Project Access Program in Richmond and Columbia County. UH provides all of the Inpatient hospitalization for the Indigent population that is approved for Project Access. UH is the only hospital in the area that is responsive to the needs of these organizations who also support the needs of the Indigent. UH provides many screenings in the community. One such screening is the PSA screening that is performed at Lowes Home Building stores. Many received the screening, some with positive results, indicating cancer. However these were caught at an early stage, thanks to these free screenings. UH's Mobile Mammography unit travels to area plants and is available for screenings at the job site during lunch. These are only a few examples of the Screenings UH provides in the community but they have tremendous impact when just one screening identifies problems that can be treated at an early stage 1 cancer verses at the later stages of cancer.
Part VI - Community Building ActivitiesThe Community Building Activities reported are support for the various Chambers of Commerces for the communities that we serve. In supporting these organizations we can support the development of our community by bringing in new industries and jobs, increasing the average household income, improving living conditions, and impacting overall general health.
Part VI - Community InformationUH resides in Richmond County, Georgia. In 2008 The Department of Community Health (state Medicaid division) issued a Georgia Health Disparities Report which listed Richmond County as having 53% Black, 44% White & the remaining 3% mostly Hispanic with some Asian, American Indian and other. 19.6% of the population is below the Federal Poverty Guidelines (FPG). 7.5% of the Adult population completing less than the 9th Grade. 9.2% of the Adult population is unemployed and 18.1 are uninsured.Surrounding Counties include : Burke County with 51% African American and 2% Latino; 28% below FPG; 21.3% with no insurance coverage and 9% unemployed. Jefferson County with 56% African American and 2% Latino; 32% below FPG; 21% with no insurance coverage and 12% unemployed. Lincoln County with 33% African American and 1% Latino; 15% below FPG; 16% with no insurance coverage and 6 % unemployed. McDuffy County with 60% African American and 4% Latino; 18% below FPG; 21% with no insurance coverage and 8% unemployed.
Part VI - Patient Education of Eligibility for AssistanceUH has the following information available to patients and visitors on the eligibility for assistance. Information is available on the University Hospital web site, patient/visitor information booklet, and UH has signage at registration and billing areas that ask "... help with your Hospital bill?" In addition, when a registering patient indicates that he/she can not afford to pay, UH will offer the Indigent and Charity Care Application (ICCP) and set up patient to speak with the Financial Assistance Office (FAO). FAO will direct patients to a Department of Family and Children (DFCS) case manager located at the hospital to see if patient qualifies for state Medicaid or the UH ICCP program. The patient may be deemed to qualify for other State/Federal assistance in which the FAO staff will help direct the patient to another group operated out of of the hospital, Resource Corporation of America (RCA), to assist with getting the patient qualified for SSI, etc.
Part VI - Needs AssessmentUH continues to use the Health needs Assessment that was completed historically which showed a need for primary health care homes for patients in the the 30901, 30906 and 30904 zip code areas (Richmond County). University established three clinics in these areas after the assessment and continues to fund and expand the support of the Primary Care Health clinics in this area. UH works with the Greater Augusta Health Care Network (GAHN) which is made up of area hospitals and primary care clinics along with the Medical College of Georgia's School of Nursing. GAHN has been collecting data showing the continued need for Primary Health Care homes for the uninsured and under insured even with the support that UH has provided. In addition to this data UH continues to rely on the national data for other opportunities to support the community; such as, Cancer screening, Mammograms, diabetes, cardiovascular clinics, obesity, etc. In addition UH works with ER personnel to identify needs based on patients seeking help through the Emergency Room. This process still shows that patients need a medical home, asthma, diabetes assistance. The programs that UH has initiated and continue to support. The Health Resources and Services Administration has designated Richmond County as a Health Professional Shortage Area (HPSA). In 2008, the State of Georgia issued a Georgia Health Disparities Report. In this report Richmond County showed above -average outcomes but some racial inequality for Access to primary care providers; even though, UH has sponsored 4 to 5 area clinics with one being designated as a Federally-Qualified Community Health Center (FQHC). Counties surrounding UH show Lincoln County, McDuffy County, Burke County, and Jefferson county as a HPSA with no FQHC having poor outcomes made worse by extremely severe racial inequalities.
Part V, Line 13g - Other Means Hospital Facility Publicized the PolicyFinancial Counselors & Access Coordinators explain to Patient and offer Financial Assistance form to patient.Number of Hospital Faciltiy - 0
Part III, Line 9b - Provisions On Collection Practices For Qualified PatientsAs outstanding balances age, statement messages, collection letters and/or telephone calls may be used at appropriate intervals determined by the Patient Accounting/Collection Department. The Patient Accounting /Collection Department recognizes that there are occasions when a patient is not financially able to pay their medical bill in full and/or the patient is experiencing financial hardship. The Hospital has established a Catastrophic Policy which allows for the Collection Department to apply the Indigent criteria and write-off as Medically Indigent. And at any point during the collection process if patient states or Patient Accounting/Collections believes that the patient can not afford to pay then an indigent/Charity Care application is begun by the Collection Department where discounts may be given.
Part III, Line 8 - Explanation Of Shortfall As Community BenefitThe services provided to the Medicare Beneficiaries are to promote the well-being of the community which is part of the Hospital charitable tax-exempt purpose. The Medicare difference between cost and Medicare reimbursment should be allowed as CB since providers can not negotiate rates with Centers for Medicare/Medicaid Services (CMS). CMS regulates that the reimbursement be federal budget neutral thus placing the cost of the caring for medicare beneficiaries as a cost to the Hospitals.
Part III, Line 4 - Bad Debt ExpensePage 8 of Audited Financial Statement: Accounts Receivable--Current Operations are charged with provisions for uncollectible accounts based upon experience and any unusual circumstances which affect the collectability of receivables. Amounts deemed uncollectible are charged against this allowance. In the opinion of managment, adequate provision has been made for uncollectible accounts.Bad Debt should be included as a Community Benefit since the services that incur bad debt are provided by the hospital to promote the well-being of the community. These services are rendered in conjunction with the Hospital's charitable tax-exempt purposes. There is no local support for uninsured patients; therefore, the services provided by the hospital relief the health care burdens of the local governments.
Part I, Line 7 - Explanation of Costing MethodologyUsed Cost to Charge Ratio calculated using Worksheet 2 --the optional worksheets provided to assist in preparation of Schedule H.
Part I, Line 3c - Charity Care Eligibility Criteria (FPG Is Not Used)Also uses Asset Test, regardless of income, to determine eligibility for free and discounted care. In addition the hospital takes into consideration Bankruptcy and financial standing when offering discounts on patient liability.

Schedule I IRS990ScheduleI

FieldValueIRS element (for citing)
Records MaintainedtrueRecordsMaintained

Recipient Table RecipientTable (9 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEIN Of RecipientEINOfRecipientIRC SectionIRCSectionAmount Of Cash GrantAmountOfCashGrantAmount Of Non Cash AssistanceAmountOfNonCashAssistancePurpose Of GrantPurposeOfGrantMethod Of ValuationMethodOfValuationDescription Of Non Cash AssistanceDescriptionOfNonCashAssistance
United Way of Greater Augusta
PO Box 1166FishersvilleVA22939540955100501(c)(3)152400Support Programs
Rape Crisis
806 13th StreetAugustaGA30901581581102501(c)(3)081264Support ProgramsMedicare Cost ReportDonated Facilities
Neighborhood Improvement Project
2467 Golden Camp RoadAugustaGA30906311491242501(c)(3)3000000Clinic Financial Support
Miracle Making Ministries
1127 Druid Park AveAugustaGA30904582358627501(c)(3)400000Clinic Financial Support
Harrisburg Family Heal
423 Crawford AveAugustaGA30904264366421501(c)(3)1200000Clinic Financial Support
Coordinated Health Services Inc
2110 Broad StreetAugustaGA30904582060572501(c)(3)16000011716Clinic Financial SupportCost of TestsLab Testing
Christ Community Health Services
519 Scotts WayAugustaGA30909205404353501(c)(3)480000174442Clinic Financial SupportMedicare Cost ReportDonated Facilities
Beulah Grove Community Resource
1446 Lee Beard WayAugustaGA30901582159621501(c)(3)6000031878Clinic Finanical SupportCost of Tests & DrugsLab Testing
American Cancer Society
250 Williams Street NWAtlantaGA30303131788491501(c)(3)130000Support Research
FieldValueIRS element (for citing)
Total Nbr Of501 C3 And Govt Grants9TotalNbrOf501C3AndGovtGrants
Total Nbr Of Other Organizations0TotalNbrOfOtherOrganizations

Form990 Schedule I Part IV Form990ScheduleIPartIV

FieldValueIRS element (for citing)
IdentifierGrantmaker's Description of How Grants are UsedIdentifier
ExplanationUniversity Health Care System does not provide "grants" to assist other organizations, but does donate funds based on the following policy and procedures: POLICY:University Health Care System is committed to the overall health and well-being of the communities it serves and recognizes the need to support other non-profit organizations who share this commitment. Corporate contributions and sponsorships are sometimes an appropriate vehicle for building partnerships with these non-profit organizations and maximizing our overall positive impact on the community.PROCEDURE1.All contribution/sponsorship requests should be submitted in writing to the Corporate Communications Department for consideration. Every effort should be made to process these requests and notify the requester within two weeks of receiving the written information required to evaluate the opportunity.2.In consultation with the CEO, the Director of Corporate Communications will prepare the annual budget for Corporate Contributions/Sponsorships and process/manage actual disbursements throughout the year.3.Requests will be evaluated based on the following criteria:a.Does the organization, event or publication promote the overall health and well-being of the communities we serve? Special consideration will be given to requests that directly impact health and wellness even though support may be available for organizations, events and/or publications that have a positive impact on the CSRA by:"assisting in attracting and retaining a viable work-force"assisting in attracting and retaining viable businesses and employers in the CSRA"promoting the continued growth and economic well-being of the community"enhancing the quality of life in the CSRAb.Does the proposed contribution/sponsorship primarily assist people locally rather than a national effort/initiative?c.Does the requesting organization have an approved tax-exempt status?d.Will the proposed contribution/sponsorship enhance the overall image/reputation of University Health Care System?e.Will the proposed contribution/sponsorship heighten awareness of a significant health issue or disease that has a negative impact on the citizens in the communities we serve?4.Under no circumstances will contributions be made to political campaigns.5.Because of the large number of public and private schools in the CSRA, University will limit financial support/contributions to the various Boards of Education rather than individual schools (elementary, middle and high schools).6.Because of the large number of churches in the CSRA, University will limit financial support/contributions to programs that include health-related services for underserved residents such as community clinics.7.Exception: Financial support and partnerships with area colleges and technical schools do not fall under this policy.Explanation

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Club Dues Or FeesXClubDuesOrFees
Written Policy Re T And E ExpensestrueWrittenPolicyReTAndEExpenses
Substantiation RequiredtrueSubstantiationRequired
Compensation CommitteeXCompensationCommittee
Independent ConsultantXIndependentConsultant
Written Employment ContractXWrittenEmploymentContract
Compensation SurveyXCompensationSurvey
Board Or Committee ApprovalXBoardOrCommitteeApproval
Severance PaymenttrueSeverancePayment
Supplemental Nonqual Retire PlantrueSupplementalNonqualRetirePlan
Equity Based Comp ArrangementfalseEquityBasedCompArrangement
Comp Based On Revenue Of Filing OrgfalseCompBasedOnRevenueOfFilingOrg
Comp Based On Revenue Related OrgsfalseCompBasedOnRevenueRelatedOrgs
Comp Based Net Earnings Filing OrgtrueCompBasedNetEarningsFilingOrg
Comp Based Net Earnings Relate OrgsfalseCompBasedNetEarningsRelateOrgs
Any Non Fixed PaymentsfalseAnyNonFixedPayments
Initial Contract ExceptionfalseInitialContractException
Rebuttable Presumption ProcedurefalseRebuttablePresumptionProcedure

Form990 Schedule J Part II Form990ScheduleJPartII (16 entries)

Base Compensation Filing OrgBaseCompensationFilingOrgBonus Filing OrgBonusFilingOrgOther Compensation Filing OrgOtherCompensationFilingOrgDeferred Comp Filing OrgDeferredCompFilingOrgNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgTotal Compensation Filing OrgTotalCompensationFilingOrg
William L Farr Jr
31200765763795182082516827494940
Teresa Waters
14857215448870161229095190107
Tara A Kattine
21217436268547905227295
Stephen M Gooden
256779256324507013268805
Shannon M Stinson MD
26954035820102246103321687
Richard W Severson
1323962900196191579515668186378
Marilyn A Bowcutt
2348805292055170535498972405491
Lynda Jones Watts
127381181592508141457365169558
Leslie A Clonch
99738318365791910107856198359
Kyle E Howell
164504370752221892238012377458525
Joan F Wessman
169184125426706814622316300
James R Davis
52019584252327522369715396846815
Edward L Burr
2396145049218915992520642372564
Dave A Belkoski
37317083500713612082521646570502
Christine A Martin
12767650444452115298817157518
Brent J Mallek
1503624631596893683221927322329

Form990 Schedule J Part III Form990ScheduleJPartIII (2 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
Sch J, Part III, Additional InformationPart III, Additional InformationSocial Club Dues- The organization pays membership fees for the CEO (James Davis) and CFO (David Belkoski) to the Augusta Country Club and the West Lake Country Club. These membership fees are paid so the organization can have access to the meeting facilities and catering services these organizations provide for meetings that are held off campus. Any personal use related to these memberships are included in the wages of the CEO and CFO.
Sch J, Part I, Line 1aPart I, Line 1a: Relevant information in regards to selections on 1a.

Schedule K IRS990ScheduleK

Form990 Schedule K Part I Form990ScheduleKPartI

Issuer Name IssuerName

FieldValueIRS element (for citing)
Business Name Line1The Richmond County Hospital AuthorityBusinessNameLine1
FieldValueIRS element (for citing)
Issuer EIN586001901IssuerEIN
CUSIP Number764603AV8CUSIPNumber
Date Issued2009-12-03DateIssued
Issue Price150901243IssuePrice
Description Of PurposeRefund Bond Certificates (Bond Series 99,03,08)DescriptionOfPurpose
DefeasedfalseDefeased
On Behalf Of IssuerfalseOnBehalfOfIssuer

Form990 Schedule K Part II Form990ScheduleKPartII

FieldValueIRS element (for citing)
Amount Retired2375000AmountRetired
Total Proceeds150901243TotalProceeds
Issuance Costs From Proceeds1243IssuanceCostsFromProceeds
Other Spent Proceeds150901243OtherSpentProceeds
Year Of Subst Completion2008YearOfSubstCompletion
Current RefundingtrueCurrentRefunding
Advance RefundingfalseAdvanceRefunding
Final Allocation MadetrueFinalAllocationMade
Adequate Books And Recds MaintaindtrueAdequateBooksAndRecdsMaintaind

Form990 Schedule K Part III Form990ScheduleKPartIII

FieldValueIRS element (for citing)
Owning Bond Financed PropertyfalseOwningBondFinancedProperty
Any Lease ArrangementstrueAnyLeaseArrangements
Mngment Cntrct Bond Financd PrprtyfalseMngmentCntrctBondFinancdPrprty
Any Research AgreementsfalseAnyResearchAgreements
Engage Bond Counsel ResearchtrueEngageBondCounselResearch
Prcntge Prvt Business Use By Others0.03000PrcntgePrvtBusinessUseByOthers
Percentage Of Prvt Business Re UBI0.00200PercentageOfPrvtBusinessReUBI
Total Private Business Use0.03200TotalPrivateBusinessUse
Post Issuance Compliance ProcdrsfalsePostIssuanceComplianceProcdrs

Form990 Schedule K Part IV Form990ScheduleKPartIV

FieldValueIRS element (for citing)
Form8038 T FiledfalseForm8038TFiled
Variable Rate IssuefalseVariableRateIssue
Hedge Identified In Books And RecdsfalseHedgeIdentifiedInBooksAndRecds
Gross Proceeds Invested In GICfalseGrossProceedsInvestedInGIC
Gross Proceeds InvestedfalseGrossProceedsInvested
Exception To RebatefalseExceptionToRebate
FieldValueIRS element (for citing)
Fed Tax Requirements ComplianceXFedTaxRequirementsCompliance

Schedule L IRS990ScheduleL

Form990 Schedule L Part IV Form990ScheduleLPartIV

Name Of Interested Person NameOfInterestedPerson

FieldValueIRS element (for citing)
Name PersonRhonda U BelkoskiNamePerson
FieldValueIRS element (for citing)
RelationshipSpouse of CFORelationship
Amount Of Transaction19092AmountOfTransaction
Description Of TransactionEmployee Compensation RNDescriptionOfTransaction
Sharing Of RevenuesfalseSharingOfRevenues

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (4 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
Form 990, Part VI, Line 19Form 990, Part VI, Line 19: Other Organization Documents Publicly AvailableAll governing documents, policies, financial statements, and informational returns are available upon request at the Administrative offices.The 990 is also available on www.Guidestar.org
Form 990, Part VI, Line 15bForm 990, Part VI, Line 15b: Compensation Review and Approval Process for Officers and Key EmployeesThe Organization follows the process described in Treasury Regulation 4958(6)(c) for establishing the rebuttable presumption of reasonableness in the review, approval, and documentation of officer, key management, and director compensation. Annually a compensation committee of the University Health Services Board, comprised of three independent board members, reviews the compensation of the CEO and other senior management members. The review is conducted in the context of a Board approved executive compensation philosophy. Both the development of the compensation philosophy and the review involve the advice and assistance of an independent compensation consulting firm. Minutes of the compensation committee are recorded. The compensation committee reports to the University Health Services Board Executive Committee.
Form 990, Part VI, Line 12cForm 990, Part VI, Line 12c: Explanation of Monitoring and Enforcement of ConflictsThe steps in the conflict of interest policy are outlined below:1.Senior management (vice presidents and above) shall complete a Potential Conflict of Interest Questionnaire periodically. Each System organization's CEO, COO, CFO and within their divisions' vice presidents may require any employee to complete a Potential Conflict of Interest Questionnaire.2.Each employee is expected to report a potential conflict of interest when it arises.3.A. An employee will report a potential conflict by initiating a Potential Conflict of Interest Disclosure Form and delivering it to his/her vice president. All employee potential conflicts will be screened by two levels of senior management to identify conflict or duality of interest situations. (A duality of interest exists when an individual has personal or outside interests that can be affected by decisions of the System. Such a duality or even multiplicity of interest can be beneficial to and consistent with the primary goals of the institutions. Duality of interest can raise the potential for conflict of interest when the personal interests of individuals come into conflict with the interests of the System.) B.When a division vice president is notified of a potential conflict/duality of interest, the vice president shall investigate the situation and make a report of his or her findings along with a recommendation to the Executive Vice President (COO) or CEO of the involved System organization.C.The Executive Vice President or CEO who received the 3.B report shall make a decision concerning a potential conflict of interest and any resolution measures to be taken. In the event the potential conflict involves a vice president, the President of University Health shall investigate the situation and make a decision concerning a potential conflict of interest and any resolution measures to be taken. This information shall be communicated directly to the concerned employee.D.The employee may appeal the conflict of interest determination to the President of University Health. The President's decision about a potential conflict of interest and any resolution measures is final and not cognizable under the Employee Grievance Policy A-30.E.In the event the potential conflict involves the CEO of any System organization, the matter shall be reported to the Chairman of the involved System organization board, who shall determine if a conflict exists and what, if any, resolution measures are necessary in accordance with that corporation's conflict of interest policy. 4.Filing of FormsA.Conflict of Interest Questionnaires of those who are required by this policy to complete one periodically shall be filed in the applicable corporation's CEO's office and retained for no less than seven years. Optional Conflict of Interest Questionnaires shall be filed in the office of the vice president who requested completion of the form.B.Completed Potential Conflict of Interest Disclosure Forms shall be filed in the applicable corporation's CEO's office for the CEO, COO, and vice presidents and for all others in the appropriate vice president's office. The forms should be retained for no less than seven years.5.The Vice President for Legal Affairs will be available to advise on potential conflict of interest matters.BOARD MEMBERS:Board Members are also required to complete a Potential Conflict of Interest Questionnaire annually. This questionnaire asks for disclosures related to any family relationships or business relationships with other board members, or business relationships with the Organization.
Form 990, Part VI, Line 11Form 990, Part VI, Line 11: Form 990 Review ProcessA copy of the 990 form and all related schedules was provided to the governing board before filing.

Schedule R IRS990ScheduleR

Form990 Schedule R Part I Form990ScheduleRPartI

Name Of Disregarded Entity NameOfDisregardedEntity

FieldValueIRS element (for citing)
Business Name Line1Walton Way Indemnity SPCBusinessNameLine1

Address Foreign AddressForeign

FieldValueIRS element (for citing)
Address Line12nd Fl Governors Sq 23 Lime TreeAddressLine1
CityGrand CaymanCity
CountryCJCountry
FieldValueIRS element (for citing)
Primary ActivitiesInsurance CaptivePrimaryActivities
Legal Domicile Foreign CountryCJLegalDomicileForeignCountry
Total Income2996567TotalIncome
EOY Assets33997497EOYAssets

Direct Controlling Entity Name DirectControllingEntityName

FieldValueIRS element (for citing)
Business Name Line1University Health Services IncBusinessNameLine1

Form990 Schedule R Part II Form990ScheduleRPartII (6 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesLegal Domicile StateLegalDomicileStateExempt Code SectionExemptCodeSectionPublic Charity StatusPublicCharityStatusBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Controlled OrgControlledOrgDirect Controlling Entity NADirectControllingEntityNA
University Hospice Inc
1350 Walton WayAugustaGA30901275008428End of Life SupportGA501(c)(3)9University Health Incfalse
University Health Inc
1350 Walton WayAugustaGA30901581581102Consolidating ParentGA501(c)(3)9falseN/A
University Health Care Foundation Inc
2100 Central Avenue Suite D-1AugustaGA30904581343550PhilantrophyGA501(c)(3)7University Health Incfalse
Augusta Resource Center on Aging Inc
4275 Owens RoadEvansGA30809581728812Non Profit Life Care CommunityGA501(c)(3)9University Health Incfalse
University Extended Care Inc
1350 Walton WayAugustaGA30901581581105Skilled Nursing HomesGA501(c)(3)3University Health Incfalse
Richmond County Hospital Authority
1350 Walton WayAugustaGA30901586001901Leased facilitiesGA501(c)(3)3falseN/A

Form990 Schedule R Part IV Form990ScheduleRPartIV

Name Of Related Org NameOfRelatedOrg

FieldValueIRS element (for citing)
Business Name Line1University Health Resources IncBusinessNameLine1

Address US AddressUS

FieldValueIRS element (for citing)
Address Line11350 Walton WayAddressLine1
CityAugustaCity
StateGAState
ZIP Code30901ZIPCode
FieldValueIRS element (for citing)
EIN581601372EIN
Primary ActivityServices to PhysiciansPrimaryActivity
Legal Domicile StateGALegalDomicileState

Direct Controlling Entity Name DirectControllingEntityName

FieldValueIRS element (for citing)
Business Name Line1University Health InBusinessNameLine1
FieldValueIRS element (for citing)
Type Of EntityC CorpTypeOfEntity
FieldValueIRS element (for citing)
Receipt Of Int Ann Rents RoyaltiesfalseReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other OrgfalseGiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other OrgfalseGiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other OrgtrueLoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other OrgfalseLoansOrGuaranteesFromOtherOrg
Sale Of Assets To Other OrgfalseSaleOfAssetsToOtherOrg
Purchase Of Assets From Other OrgfalsePurchaseOfAssetsFromOtherOrg
Exchange Of AssetsfalseExchangeOfAssets
Rental Of Facilities To Other OrgsfalseRentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other OrgstrueRentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other OrgsfalsePerformOfServicesForOtherOrgs
Perform Of Services By Other OrgstruePerformOfServicesByOtherOrgs
Sharing Of FacilitiesfalseSharingOfFacilities
Sharing Of Paid EmployeestrueSharingOfPaidEmployees
Reimbursement Paid To Other OrgfalseReimbursementPaidToOtherOrg
Reimbursement Paid By Other OrgfalseReimbursementPaidByOtherOrg
Other Transfer To Other OrgfalseOtherTransferToOtherOrg
Other Transfer From Other OrgfalseOtherTransferFromOtherOrg